ArticleEClinicalMedicine2025
Shorter versus longer-duration antibiotic treatments for immunocompetent patients with bloodstream infections: a systematic review and meta-analysis.
Article in EClinicalMedicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed.
- Reassessing Antibiotic Duration in Dental Infections: A Narrative Review and Marginal Benefit-Harm Framework with a Clinical Checklist.Antibiotics (Basel, Switzerland) · 2026Review
- Sepsis in Italian departments of internal medicine: an increasing challenge.Internal and emergency medicine · 2026Article
- Oral transition therapy versus intravenous therapy for the treatment of uncomplicated Enterococcal bloodstream infections.Infection · 2026Article
- Seven versus fourteen days for resistant bloodstream infections: what do we actually know? A scoping review.Infection · 2026Review
- Shorter versus longer-duration antibiotic treatments for immunocompetent patients with bloodstream infections: a Bayesian perspective.EClinicalMedicine · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The optimal duration of antibiotic treatment for bloodstream infections remains uncertain. This study aimed to compare the efficacy and safety of shorter versus longer duration antibiotic treatment for immunocompetent patients with bloodstream infections. Methods: We searched Medline, Embase, and Cochrane Central Register of Controlled Trials without language restrictions for randomized controlled trials (RCTs) published between database inception and 25 November 2024, comparing shorter-duration antibiotic treatments with longer-duration antibiotic treatments in patients with bloodstream infections with a minimum difference of 3 days in duration of therapy. We employed random-effects meta-analyses to summarize the evidence. We used the mean difference (MD) with 95% confidence intervals (CIs) for continuous outcomes. For dichotomous outcomes, we used the odds ratios (ORs) or risk ratios (RRs) with 95% CIs. We used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework to assess the certainty of evidence. This study is registered with Open Science Framework (https://osf.io/egs8q). Findings: Eleven RCTs published between 2006 and 2025, involving a total of 5505 participants, proved eligible. There are probably little or no differences in mortality (RR 0.91, 95% CI 0.79-1.05; moderate certainty), treatment failure (RR 1.08, 95% CI 0.69-1.68; moderate certainty), and relapse rates (RR 1.15, 95% CI 0.82-1.63; moderate certainty) between shorter- and longer-duration antibiotics. Compared with longer-duration antibiotics, shorter-duration antibiotics do not increase hospital readmission (RR 0.91, 95% CI 0.75-1.1; high certainty), but reduce the length of hospital stay (MD -3.04, 95% CI -3.9 to -2.18; high certainty). With very low certainty evidence, we are uncertain whether shorter-duration antibiotics decrease any adverse events (RR 1.0, 95% CI 0.76-1.32) and serious adverse events (RR 0.67, 95% CI 0.39-1.14) compared with longer-duration antibiotics. Interpretation: Shorter- and longer-duration antibiotics show similar efficacy for bloodstream infections, with shorter courses reducing hospital stay. Consistent effects were observed across age groups and bacterial types, but cautious interpretation is needed due to limited subgroup data. Funding: None.
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